摘要
目的基于主动健康理念与能力-机会-动机-行为(COM-B)模型,系统评价脑卒中患者健康行为的影响因素。方法采用混合方法系统评价设计,计算机检索PubMed、Web of Science、Cochrane Library、SinoMed、中国知网、万方数据知识服务平台、维普网,筛选建库至2025年2月关于脑卒中患者主动健康行为的相关研究,对纳入文献采用基于数据的聚敛整合法进行分析。结果共纳入18篇文献。整合结果显示:脑卒中患者主动健康行为的影响因素包括能力因素(脑卒中知识与技能、认知能力、身体功能、自我管理能力)、机会因素(社会支持与资源、环境与文化、医疗配置与经济资源、工作与职业)和动机因素(自我效能、健康信念与态度、风险意识与规划、心理状态)。结论脑卒中患者的主动健康行为是一个涉及患者自我管理与外部支持系统共同作用的复杂过程,受到多种因素的综合影响。医护人员应从多角度出发,提供必要的健康教育与康复技能培训提升患者的能力,创造有利的外部环境,帮助患者调整心理状态、提升健康信念与自我效能感等,进而提高主动健康行为水平。
Objective To systematically evaluate factors influencing health behaviors in stroke patients using the Active Health framework and the Capability Opportunity Motivation-Behavior(COM-B)model.Methods A mixed-methods systematic review was conducted.Databases including PubMed,Web of Science,Cochrane Library,SinoMed,China National Knowledge Infrastructure(CNKI),WanFang Data,and VIP,were systematically searched for studies on health behaviors in stroke patients published until February 2025.A convergent integrated approach was utilized to synthesize quantitative and qualitative data.Results A total of 18 studies were included.The integrated results identified influencing factors across COM-B dimensions:capability(stroke-related knowledge and skills,cognitive function,physical functioning,and self-management ability),opportunity(social support and resources,environmental and cultural contexts,healthcare infrastructure and economic resources,work and occupation),and motivation(self-efficacy,health beliefs and attitudes,risk awareness and action planning,mental state).Conclusion Active health behaviors in stroke patients emerge from complex interactions between self-management capacity and external support systems,and are affected by multifaced factors.Healthcare providers should enhance patients′capacity through disease-specific education and functional rehabilitation training,optimize opportunity by cultivating supportive environments,and strengthen motivation by adjusting mental state and enhancing health beliefs,thus to promote their active health behaviors.
作者
周欣馨
张孟羽
谢钰莹
赵鹏
常安妮
连秀玉
郭丽娜
刘延锦
Zhou Xinxin;Zhang Mengyu;Xie Yuying;Zhao Peng;Chang Anni;Lian Xiuyu;Guo Lina;Liu Yanjin(School of Nursing and Health,Zhengzhou University,Zhengzhou 450001,China)
出处
《护理学杂志》
北大核心
2025年第16期101-106,共6页
Journal of Nursing Science
基金
国家自然科学基金资助项目(72204225,72274179)
中国博士后科学基金项目(2023M733234)。
关键词
脑卒中
主动健康
健康行为
健康促进
能力-机会-动机-行为模型
影响因素
混合方法系统评价
stroke
active health
health behaviors
health promotion
influencing factors
Capability Opportunity Motivation-Behavior model
mixed-methods systematic review
